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Asthma (Adult) — UKMLA MCQ

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HardRespiratoryAsthma (Adult)UKMLAMRCGP AKTPARAMRCP Part 1PSA

A 24-year-old man with mild intermittent asthma uses salbutamol twice weekly. Night symptoms twice a month. According to UK guidance, what is the preferred next step?

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Correct answer: B — As-needed low-dose ICS-formoterol; after baseline safety checks with planned monitoring of treatment response and tolerance

The best answer is “As-needed low-dose ICS-formoterol; after baseline safety checks with planned monitoring of treatment response and tolerance”. For adults/adolescents with symptoms more than very infrequently, as-needed low-dose ICS-formoterol is recommended to reduce exacerbations; daily low-dose ICS (B) is an alternative. SABA alone (A) increases exacerbation risk. LABA without ICS (C) is unsafe. Montelukast monotherapy (D) is less effective. The cited UK authority supports this decision in the stated clinical context. The competing choices are clinically recognisable alternatives, but they are less appropriate because they either delay the required intervention, treat a different severity or mechanism, omit a necessary co-treatment, or introduce avoidable harm. Patient-specific contraindications and monitoring still apply.

Reference: NICE NG245: Asthma — diagnosis, monitoring and chronic management: https://www.nice.org.uk/guidance/ng245/chapter/Recommendations